Rotator Cuff Tendon Barbotage

Calcific tendonitis of the rotator cuff tendons is one of the most painful conditions a person can experience. This is caused by crystals depositing in tendon. Crystals are like tiny knives every time you move your shoulder its like a microscopic razor!!

The first line treatment for calcific tendonitis of the rotator cuff is high-dose inflammatory drug s like ibuprofen or indocin.

If medication doesn’t work the next option is tendon barbotage or surgery. Surgery involves going to see an orthopedic surgeon, getting xrays, an ultrasound or MRI or both to evaluate the calcium. The patient then gets scheduled for surgery and the surgeon makes a small incition into the shoulder and scrapes out the calcium and sutures the tendon back together. The recovery is similar to rotator cuff surgery and can take 12 weeks.

Tendon barbotage and lavage is done using ultrasound guidance. The radiologist finds the calcium using ultrasound and then numbs the area with local anesthetic. A needle is then passed into the calcium to break it up and fluid is flushed in to the area to dissolve and wash out the calcium. The radiologist will then inject steroid in the bursa and the shoulder joint.

Most patients feel better immediately and have 90-100% improvement within a few days. You have to restrict heavy lifting for 2 weeks and then you are free to do home therapy or physical therapy to continue to improve strength.